BRITISH MEDICAL JOURNAL
26 FEBRUARY 1977
549
SHORT REPORTS IgA deficiency during D-penicillamine treatment The most common immunodeficiency is a selective lack of IgA, which is found in about 1/700 in the general population.' In some instances family cases are found, but usually IgA deficiency seems to be isolated. Against this background it is of great interest to note that IgA deficiency can be induced by phenytoin.2 Recently we observed in a girl with Wilson's disease diminishing IgA levels during treatment with penicillamine. This suggests that exogenous factors have a role in IgA deficiency. Case report The patient was a 12-year-old previously healthy girl presenting with haemolytic anaemia, succeeded by macroscopic haematuria, oedema of the legs, and severe liver dysfunction with low serum albumin (23 g/l) and definitely raised immunoglobulin concentrations (IgG 28, IgA 9, and IgM 4-2 g/l). Complement factors were depressed: C3
26 FEBRUARY 1977
549
SHORT REPORTS IgA deficiency during D-penicillamine treatment The most common immunodeficiency is a selective lack of IgA, which is found in about 1/700 in the general population.' In some instances family cases are found, but usually IgA deficiency seems to be isolated. Against this background it is of great interest to note that IgA deficiency can be induced by phenytoin.2 Recently we observed in a girl with Wilson's disease diminishing IgA levels during treatment with penicillamine. This suggests that exogenous factors have a role in IgA deficiency. Case report The patient was a 12-year-old previously healthy girl presenting with haemolytic anaemia, succeeded by macroscopic haematuria, oedema of the legs, and severe liver dysfunction with low serum albumin (23 g/l) and definitely raised immunoglobulin concentrations (IgG 28, IgA 9, and IgM 4-2 g/l). Complement factors were depressed: C3
